Psychiatric hospitals make their patients worse before they start making them better. Their admission procedures re-traumatize people who are already traumatized. Not much can be done about that because hospital managements claim these traumatic admission procedures are needed to protect staff and other patients.
This is not about whether psychiatric medicines and hospitals, and public mental health systems, produce bad long-term outcomes for many people. It’s about the vast majority of people who enter psychiatric hospitals in a crisis, and are released. stable on medication, in less than two months, often in just a few days.
A Traumatized Population
Any psychiatric event that triggers police involvement or admission to a hospital is traumatic “by definition,” Kim Meuser, Ph.D., said in the Journal of Psychiatric Rehabilitation in Summer, 2002.
He said 65 percent of the adult clients in the public mental health system – 80-plus percent of the adult women – have trauma in their backgrounds.
“Trauma is so common in this population, it’s normative,” he said.
Other people, like Mary Ellen Copeland, Ph.D., say 100 percent of the public mental health system’s clients deal with trauma because any psychiatric event or condition that qualifies a person for treatment in a public mental health system is traumatic.
When a person dealing with trauma is re-traumatized, all the feelings connected with all previous traumas come back as if they are happening now, most experts say. The person does not know this is what’s happening, just that he or she is having an over-the-top emotional reaction to what looks to others like a minimal trigger.
The reaction can be rage, acute depression, withdrawal, suicidal feelings, substance abuse, hallucinations, or any number of reactions that can be mistaken for symptoms of a chemical brain disease. In fact, these emotional reactions to trauma are normal human reactions to abnormal events, not mental illness at all.
Traumatic Admission Procedures Cause Setbacks
Before a person is settled into a hospital routine, and starts getting better, a family member or care provider decides he is so far gone the only thing to do is call the police and have the person carted to the loony bin in handcuffs, involuntarily.
Everyone who is transported anywhere in a police car must be handcuffed. It’s policy, not about the person or mental illness. That won’t change because a police officer’s first concern must be officer safety, and his second concern must be public safety.
Major Sam Cochrane of the Memphis Police, who invented crisis intervention training (CIT) for police responding to mental health calls, teaches several ways an officer can make handcuffing less traumatic, but can’t eliminate the trauma.
That’s two traumatic admission procedures.
When the patient arrives at the hospital, a stranger searches his belongings and takes away whatever he wants, including the patient’s cigarettes.
After a lot of questions and paperwork, the traumatized patient is taken to a locked ward and told he can’t leave until he earns “privileges.” That’s three more traumatic admission procedures, assuming the patient is not sent to seclusion or put in restraints
So before the hospital starts stabilizing the patient’s moods, convincing him that the hospital and the world are safe, trustworthy places where he has some control, and restoring his autonomy and ability to trust, it takes away what little autonomy, trust, sense of safety, and control he has left.
Don’t expect any of this to change much. Hospitals say these traumatic admission procedures are necessary to protect the safety of the staff and other patients.
Even relatively sensitive hospitals, like NH Hospital, where I’m a recovery consultant, where they’ve made great strides reducing seclusion, restraint, and conditional discharge (outpatient commitment), traumatic admission procedures remain nearly unchanged.
What traumatic admission procedures affected you, or someone you know?